‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the typical causes related to a house full of loud preteen kids, but since it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis down with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|